Healthcare Provider Details

I. General information

NPI: 1245817949
Provider Name (Legal Business Name): LILI SWEENEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2021
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 HERLONG AVE S
ROCK HILL SC
29732-1159
US

IV. Provider business mailing address

3800 S OCEAN DR STE 209
HOLLYWOOD FL
33019-2915
US

V. Phone/Fax

Practice location:
  • Phone: 800-226-8874
  • Fax: 877-366-4776
Mailing address:
  • Phone: 800-226-8874
  • Fax: 877-366-4776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number001016414
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5715
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: